Claims Service Specialist IV - Commercial Lines Bodily Injury

Arbella•Quincy, MA

22d

About The Position

Under minimal supervision, this role is responsible for investigating and resolving first and third-party material damage, WC, PIP, and BI claims. The position may involve complex issues related to coverage, liability, damages, and legal matters, with a potential focus on large exposure claims in Commercial Auto, Homeowner liability, and Commercial Property. The specialist will provide guidance to legal counsel during litigation to ensure favorable resolutions and will mentor new employees. Key responsibilities include timely case management, maximizing customer service, minimizing loss payouts, contacting relevant parties, investigating losses, evaluating case facts for coverage and liability, interpreting medical reports, negotiating settlements, pursuing subrogation and salvage, preparing damage scopes, assisting with expert selection, managing litigation, and participating in special projects and training. The role also involves training junior claims specialists and keeping management informed of activities and issues.

Requirements

Excellent communication, customer service, and collaboration skills
5+ years of progressive Claim Adjuster experience
Demonstrated success in handling PIP and BI
Sound experience in Commercial Lines
Valid driver’s license in good standing

Nice To Haves

Pass state licensing requirements where applicable (RI, NH, CT)

Responsibilities

Investigate and resolve first and third-party material damage, WC, PIP, and BI claims.
Handle claims involving coverage, liability, damage, and legal issues.
Concentrate on large exposure claims, Commercial Auto, Homeowner liability, and/or Commercial Property claims.
Provide guidance and direction to legal counsel during the litigation process.
Act as a mentor to new employees.
Ensure timely completion of all case activities, maximizing customer service and minimizing net loss payout.
Contact insureds, claimants, and witnesses in person, by telephone, or in writing.
Visit accident locations to examine, photograph, and diagram physical facts, and conduct neighborhood canvasses.
Input and retrieve information using the automated claims system.
Request checks, form letters, and other correspondence through the automated claim system.
Evaluate case facts to determine coverage, liability, and reserves, and report on settlement.
Maintain a reminder system for case activities.
Evaluate case facts to confirm coverage and appropriate damages.
Interpret and evaluate medical reports for applicability to the claim.
Monitor legal and medical billings and investigate for proper charges.
Negotiate settlements with individuals, attorneys, and other insurance carriers within granted settlement authority.
Pursue subrogation and arrange for salvage to obtain maximum recovery.
Prepare detailed scope of damages on property losses and bring them to resolution.
Assist in the selection and evaluation of experts as needed.
Manage litigation, ensuring coverages are not exceeded and legal expenses are adequate.
Confer with attorneys about case direction and disposition.
Participate in special projects or training programs.
Successfully complete all required training and apply knowledge.
Assist in the training of Claims Service Specialists III and below.
Keep management informed of activities and issues within assigned area of responsibility.
Perform other related duties as required or requested.